Rocky mountain spotted fever - Altmeyers Encyclopedia

Synonym(s)

Rocky Mountain Fever; Tick-bite fever of the new world

Definition
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Tick-borne rickettsiosis with centrifugally spreading exanthema.

Pathogen
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Rickettsia rickettsii.

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Occurrence/Epidemiology
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Worldwide distribution; more common in North or South America (especially during the spring or summer months).

Etiopathogenesis
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Infection with R. rickettsii transmitted by Dermacentor variabilis (American dog tick), forest ticks or rat ticks.

Manifestation
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Mostly occurring in children from LJ 4-10.

Clinic
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Incubation period 2-14 days after tick bite. Occasionally, an ulcerated nodule up to the size of a pea can be found at the bite site, which can be covered with a black crust (tache noire). Morbilliform, possibly hemorrhagic exanthema. Usually starts at wrists and ankles. Skin necrosis possible. Nosebleed, splenohepatomegaly, fever.

Complication(s)(associated diseases
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Cerebral involvement, damage to kidney and liver.

Therapy
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S.u. Rickettsialpox.

Progression/forecast
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Letality without antibiotics 5-25%.

Literature
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Elghetany MT, Walker DH (1999) Hemostatic changes in Rocky Mountain spotted fever and Mediterranean spotted fever. At J Clin Pathol 112: 159-168
Masters EJ et al (2003) Rocky Mountain spotted fever: a clinician's dilemma. Arch Internal Med 163: 769-774
O'Reilly M et al (2003) Physician knowledge of the diagnosis and management of Rocky Mountain spotted fever: Mississippi, 2002 Ann NY Acad Sci 990: 295-301